A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy

Jirapinyo, Pichamol; Jin, David X.; Qazi, Taha; Mishra, Nitin; Thompson, Christopher C.

doi:10.1007/s11695-017-2913-1

Cited by 71 publications

(39 citation statements)

References 52 publications

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“…Changes in levels of leptin, PYY, and GLP-1 after RYGB were also reported in some of the included studies [27,30,35,37]. To speak of GLP-1, a meta-analysis of Pichamol Jirapinyo et al indicated that fasting levels remained unchanged while postprandial GLP-1 levels increased after RYGB and the latter were negative related with alimentary limb length [48]. However, our meta-regression results did not support a relationship between ghrelin levels and RYGB surgical technical characteristics (including gastric pouch volume, alimentary limb length, and biliopancreatic limb length).…”

Section: Discussionmentioning

confidence: 90%

Systematic Review and Meta-analysis of the Change in Ghrelin Levels After Roux-en-Y Gastric Bypass

Pang

Chen

et al. 2019

OBES SURG

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Background Roux-en-Y gastric bypass (RYGB) is considered effective for weight loss and for treatment of many obesity-related metabolic diseases. Ghrelin is an essential orexigenic peptide that plays an indispensable role in controlling body weight and energy homeostasis of post-operative patients. This systematic review and meta-analysis aimed to investigate changes in the level of fasting total ghrelin following RYGB. Methods A systematic literature search of PubMed, EMBASE, and the Cochrane Library until April 2018 with keywords Bghrelin^and Bgastric bypass^was performed in accordance with the MOOSE guidelines and PRISMA statement. Three reviewers independently selected the studies and extracted data. Quality assessment of the included studies was undergone. A random effects model was employed to calculate overall effect sizes. Subgroup analyses and meta-regression were subsequently performed. Results Sixteen studies with 325 patients were included. We found ghrelin levels had an increasing tendency (SMD = 0.30; 95% CI = 0.04 to 0.57) despite moderate heterogeneity (I 2 = 58%). Subsequent subgroup analysis indicated that ghrelin levels decreased (SMD = − 0.49; 95% CI = − 0.98 to 0.00) in the short term (≤ 3 months) and increased (SMD = 0.46; 95% CI = 0.22 to 0.69) in the long term (> 3 months) after RYGB. Meta-regression showed that gastric pouch volume, alimentary limb length and biliopancreatic limb length were not associated with changes in ghrelin levels. Conclusion Fasting total ghrelin levels decreased in the short term (≤ 3 months) and increased in the long term (> 3 months) after RYGB.

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Section: Discussionmentioning

confidence: 90%

Systematic Review and Meta-analysis of the Change in Ghrelin Levels After Roux-en-Y Gastric Bypass

Pang

Chen

et al. 2019

OBES SURG

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“…It has been shown that Roux-en-Y gastric bypass (RYGB) surgery results in significant increases in postprandial glucagon-like peptide-1 (GLP-1) levels. 4 Following treatment with exenatide, a GLP-1 receptor agonist, a fall in systolic blood pressure was reported. 5 All GLP-1 receptor agonists have been shown to consistently reduce systolic blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Decreases in neprilysin and vasoconstrictors and increases in vasodilators following bariatric surgery

Ghanim

Monte

Caruana

et al. 2018

Diabetes Obesity Metabolism

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The aim of this study was to determine if weight loss following Roux-en-Y gastric bypass (RYGB) surgery in morbidly obese patients is associated with a decrease in plasma concentrations of neprilysin, mediators of the renin angiotensin system (RAS), catecholamines and endothelin-1, and also with an increase in the concentrations of vasodilators. Fasting blood samples were obtained from 15 patients with morbid obesity and diabetes prior to and 6 months after RYGB surgery. Circulating levels of neprilysin, vasoconstrictors, vasodilators, and the mRNA expression of related genes in circulating mononuclear cells (MNC) were measured. Six months after RYGB surgery the concentrations of neprilysin, angiotensinogen, angiotensin II, renin and endothelin-1 fell significantly by 27 ±16%, 22 ±10%, 22 ±8%, 35 ±13% and 17 ±6% (P < .05 for all), respectively, while ANP concentrations increased significantly by 24 ±13%. There was no significant change in aldosterone, BNP, cAMP or cGMP concentrations, or angiotensin converting enzyme (ACE) expression. These changes may contribute to the reduction of congestive cardiac failure and blood pressure risks after RYGB surgery.

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“…This may lead to a decrease in the secretion of unidentified duodenal factors that usually promote insulin resistance and T2D (13). Alternatively, the hindgut hypothesis proposes that RYGB leads to early delivery of nutrients to the distal small bowel, which then stimulates L cells in the terminal ileum and proximal colon to secrete more glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and other hormones (14). These ultimately lead to enhanced insulin secretion by pancreatic b-cells and decreased insulin resistance (15,16).…”

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confidence: 99%

Effect of the Duodenal-Jejunal Bypass Liner on Glycemic Control in Patients With Type 2 Diabetes With Obesity: A Meta-analysis With Secondary Analysis on Weight Loss and Hormonal Changes

2018

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A Meta-Analysis of GLP-1 After Roux-En-Y Gastric Bypass: Impact of Surgical Technique and Measurement Strategy

Abstract: Postprandial GLP-1 levels increase after RYGB, while fasting levels remain unchanged. Shorter Roux limb length is associated with greater increase in postprandial GLP-1, which may lead to better glycemic control in this population.

Cited by 71 publications

References 52 publications

Systematic Review and Meta-analysis of the Change in Ghrelin Levels After Roux-en-Y Gastric Bypass

Systematic Review and Meta-analysis of the Change in Ghrelin Levels After Roux-en-Y Gastric Bypass

Decreases in neprilysin and vasoconstrictors and increases in vasodilators following bariatric surgery

Effect of the Duodenal-Jejunal Bypass Liner on Glycemic Control in Patients With Type 2 Diabetes With Obesity: A Meta-analysis With Secondary Analysis on Weight Loss and Hormonal Changes

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